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What Stanford president's resignation means for team science, medical education catches up to GPT-4, & a genetic cheat code for symptom-free Covid

July 20, 2023
Reporter, Morning Rounds Writer
Good morning. Before we get to Jonathan Wosen's analysis of Stanford President Marc Tessier-Lavigne's resignation after the university found he failed to "decisively and forthrightly" correct research, I have to tell you about a British medical journal's refusal to retract a roundly criticized paper often cited to restrict abortion in the U.S., per an investigation by the BMJ and BBC Newsnight.

academia

Who gets the credit — or blame —  in team science?

Marc_Tessier_Lavigne

Photo illustration: Alex Hogan/STAT; photo: Getty Images

Marc Tessier-Lavigne's resignation yesterday as president of Stanford following an investigation into past research irregularities means more than just a top university's change of command. Faulted for not correcting data manipulation in scientific papers he co-authored, Tessier-Lavigne represents a scientific enterprise in which lab leaders get most of the attention for work performed by postdocs, grad students, and other lab members whom they supervise and critique with big-picture feedback.

Science is a team sport, STAT's Jonathan Wosen reminds us in his analysis of Tessier-Lavigne's fall. So who's responsible for the accuracy and fidelity of scientific papers that bear all their names? Tessier-Lavinge himself took some blame for not ensuring safeguards were in place to spot the image manipulation others found, dating to a 2009 Nature paper published during his time at the biotech Genentech. "Going forward, I will be further tightening controls," he wrote in a statement about his resignation.


pandemic

Some people have a genetic cheat code for avoiding Covid symptoms

Maybe the most insidious trait of the SARS-CoV-2 virus is its talent for silently spreading among contagious people who didn't feel sick. That's different from the original SARS, transmitted only when a person is showing symptoms. Other viruses, like the flu, can be spread a day or two before symptoms appear. Studies suggest that more than half of pre-vaccine Covid-19 cases were transmitted from symptom-free infected people. About 40% of these symptom-free spreaders never got so much as a sniffle. But why?

It's in their genes, scientists report in a Nature study. They found a mutation that increases a person's chance of being asymptomatic by nearly tenfold. This version of an HLA gene is so good at picking up other coronaviruses — think seasonal colds — that look like SARS-CoV-2, the body already has specifically targeted T cells to fight it off. So no pitched battle, no symptoms, STAT's Megan Molteni explains.


obesity

What TikTok gives, TikTok can also take away

Much of the excitement about the new class of weight loss drugs has been fueled by enthusiasm on TikTok. No more. The social media suspended dozens of accounts early this month, many belonging to content creators who talk about their weight loss and make money via partnerships with telehealth companies that prescribe GLP-1s and similar medications. 

The reason: "We remove content and ban accounts that promote disordered eating or dangerous weight loss behaviors and do not permit ads for weight loss drugs or supplements," TikTok spokesperson Jessica Allen emailed STAT's Katie Palmer. Also caught in the fray are accounts run by physicians and founders of virtual weight management companies that prescribe GLP-1s. "A lot of patients that are using these medications, they were sharing their stories, and I think for them this was a big part of their community," said physician Myra Ahmad of digital obesity company Mochi Health. Read more.



Closer Look

Time to prepare, not panic: Medical trainees take ChatGPT for a test run

Second-year internal medicine resident Son Quyen Dinh points at ChatGPT's output during a resident workshop at Beth Israel Deaconess Medical Center.
Brittany Trang/STAT

What happens if you ask a roomful of medical trainees to solve a diagnostic riddle — and, by the way, consult Dr. ChatGPT? Internal medicine residents at Beth Israel Deaconess Medical Center in Boston rose to the occasion when asked to weigh in on the case of a 39-year-old woman with fever and pain in her left knee. Large language models like GPT-4 have barely entered clinical practice, but their footprint is expected to expand. So it's time for medical educators to prepare, not panic. 

On this day, the workshop tested the limits and potential of AI. "The takeaway is that GPT-4 is likely able to serve as a thought partner or an adjunct to an experienced physician who is stumped in a case," said Beth Israel Deaconess's Adam Rodman. The question is how carefully doctors can learn to incorporate its outputs. STAT's Katie Palmer and Brittany have more — including the correct diagnosis.


in the lab

A new atlas maps the kidney

Behold the kidney, one of the most architecturally complex organs in the human body. Pulling from years of work and all the "-omics" out there, researchers have unveiled a detailed atlas in Nature. The resource, which could be key to understanding kidney diseases, will make it easier to pin down 51 main cell types, 28 kidney injury cellular states, and 1.2 million injury neighborhoods. "You have unhappy neighbors shouting at each other. And we learn exactly what words are used, meaning what genes are expressed," paper co-author Matthias Kretzler said. 

One in every seven adults has chronic kidney disease, the CDC estimates, but most of them don't know they're ill until later stages of disease when symptoms appear. The hope is that the kidney atlas can get scientists on the same page and push the field toward some breakthroughs after decades of relative stagnation. STAT's Isabella Cueto tells us there's more to do.


global health

Gavi's outgoing leader reflects on vaccinating 'an eighth of humanity'

Seth BerkleyFabrice Coffrini/AFP via Getty Images

Seth Berkley (above) has watched Gavi, the Vaccine Alliance, grow from a small secretariat into a global powerhouse advancing new vaccines and expanding coverage, especially in lower-income countries. "Gavi has vaccinated more than a billion individual children," he told STAT's Helen Branswell as he nears retirement as CEO next month. "That's half of the world's children every year. Right now an eighth of humanity has received a Gavi vaccine." Some questions and answers:

Could the Covid vaccine market crater in the next couple of years?

If we do not have new big outbreaks, changing disease patterns, etc., it may be that people will not continue to get annual shots. That would change if we had a pan-coronavirus vaccine, or we had a vaccine that prevented infection in addition to disease.

As you look to the future, what worries you about this sphere?

I think we're going into an era of poly-epidemics.

Read the full interview.


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